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Provides direct nursing care including assessments, care plan, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates the delivery of care provided by other...

Humana Inc. is seeking a Telephonic Nurse 2 Care Manager to assess and plan care for members over the phone, coordinating with families and healthcare resources to support optimal wellness. The role emphasizes independent assessment, care...

Job Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities for primary care...

CVS Health is seeking an experienced RN to review clinical documentation and apply appropriate criteria for post-service claims. You will coordinate resolutions with clinicians as needed and support customer service and claims teams. The role...

Registered Nurse Scheduled Weekly Hours: 36 Work Shift: Nights (United States of America) THIS IS A COLLECTIVE BARGAINING UNIT POSITION Mercy Health St. Vincent Join our team today! Higher Pay Scales and...

Description: Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs,...

Sentara Health Plans Community Care seeks a Utilization Review Nurse (RN) in Norfolk, VA. The role supports utilization management, including prior authorization, pre-certification, and care coordination to ensure treatment aligns with medical...

Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

Job Description: The Licensed Practical Nurse (LPN) performs a variety of delegated nursing tasks and participates in patient care within their Scope of Practice, guided by registered nurses, licensed physicians, or other specified health care...

Description CNA - Sub Acute at Providence Little Company of Mary Medical Center in San Pedro, CA. Positions available are Full Time Day that will work 12-hour shifts. Providence Little Company of...

The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and discharges, ensuring appropriate levels of care and compliance with regulations. This role is ideal for those who excel in a fast-paced...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a...

Humana is seeking a Registered Nurse Care Manager in Wisconsin to support Family Care program members. This role offers daytime hours, no nights or weekends, with travel to member visits and occasional remote work from home. You will assess...

CVS Health is hiring a fully remote Clinical Claim Review Nurse. The role follows a Monday–Friday, 8am–5pm schedule in the candidate's time zone. You will review outpatient therapy records, interpret data, and apply clinical criteria in line...

Tier 3 - System Flex Team Traveler Registered Nurse (RN) A Tier 3 - System Flex Team Traveler Registered Nurse (RN) is expected to be assigned to various sites throughout the Bon Secours Mercy Health System to provide patient care...

Unit Notes - Unit: PACU - # beds: 15 cubicals - Phase 1 and Phase 2: Phase 1 just be knowledgable of Phase 2 - Certs: BLS, ACLS, PALS, preferred-CPAN or CCRN- 2 years of recovery/ICU experience. 1st time traveler okay - Ratios:...

Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for a remote role. You will perform utilization management, comprehensive pre/post-payment claim reviews, and authorization assessments across inpatient, outpatient, and retrospective...

Medix is seeking a Remote Utilization Review Registered Nurse (UR RN) to bridge clinical care and hospital operations from a remote setting. Join a team optimizing patient care while safeguarding revenue integrity, with a compressed 4-day week,...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Details Client Name California Hospital Medical Center Job Type Travel Offering Nursing Profession Registered Nurse...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...